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Taking a human rights approach to health care commercialisation. Dr Brigit Toebes, The University of Aberdeen School of Law b.toebes@abdn.ac.uk. Health and Human Rights. http://www.abdn.ac.uk/law/hhr.shtml : Honours course ‘Health and Human Rights’

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taking a human rights approach to health care commercialisation

Taking a human rights approach to health care commercialisation

Dr Brigit Toebes,

The University of Aberdeen

School of Law

b.toebes@abdn.ac.uk

Toebes, April 2007

health and human rights
Health and Human Rights

http://www.abdn.ac.uk/law/hhr.shtml :

  • Honours course ‘Health and Human Rights’
  • ‘Monitoring the Right to Health: a Multi-country study’
  • Research on health care commercialisation
  • PhD Research Dabney Evans on Race and Health

Toebes, April 2007

where do i come from
Where do I come from
  • Research on ‘Right to Health’
  • Advising on the privatisation of the Dutch health care system

Toebes, April 2007

health care commercialisation
Health care commercialisation

Human rights law:

  • neutral
  • yet: serious human rights consequences

Toebes, April 2007

this presentation
This presentation
  • Terminology
  • Rationale and causes
  • Trends
  • Public health perspective
  • Human Rights perspective
  • A ‘human rights impact assessment’

Toebes, April 2007

terminology
Terminology
  • Privatisation?
  • Commercialisation?

Toebes, April 2007

rationale curb public spending
Developed countries

Inefficiency

Ageing of the population

Improvements of medical techniques

Rising expectations

Over-consumption?

Developing countries

Inefficiency

General poverty on the part of the government

Pressure from IFI’s and TNC’s

Rationale: curb public spending

Toebes, April 2007

the promise

The promise:

Enhance the consumer’s range of choice

Toebes, April 2007

trends
Trends
  • health insurance
  • health care provision
  • multinational expansion

Toebes, April 2007

bma 2006

BMA - 2006

‘There should be no further involvement of the commercial private sector in providing NHS care. The BMA will campaign to restore an integrated publicly provided health service in England.’

Toebes, April 2007

the public health perspective
The public health perspective

Mackintosh and Koivusalo:

  • More of GDP spent by government or social insurance funds on health care: better care at birth;
  • Higher primary care commercialisation: greater exclusion of children from treatment when ill.

Toebes, April 2007

their conclusion
Their conclusion:
  • ‘Health systems are part of the public policy sphere’
  • ‘Policies towards commercialization within health systems should and can be within national and local democratic control’

Toebes, April 2007

the human rights perspective

The human rights perspective?

‘Human rights impact assessment’

Toebes, April 2007

relevant human rights
Relevant human rights
  • Rights to information and political participation
  • Right to health
  • Right to a remedy
  • Right to privacy

Toebes, April 2007

information and political participation

Information and political participation

Information and consultation

of the public

Toebes, April 2007

right to health
Right to health
  • AAAQ
  • Minimum core
  • ‘obligation to protect’

Toebes, April 2007

slide17
AAAQ
  • Availability
  • Accessibility

Non-discrimination

Physical accessibility

Affordability

Information accessibility

  • Acceptability
  • Quality

Toebes, April 2007

minimum core obligations
Minimum core obligations
  • Programme of Action ICPD
  • Primary Health Care WHO
  • Millennium Development Goals

Toebes, April 2007

obligation to protect
Obligation to protect
  • Regulate
  • Monitor
  • Provide redress

Toebes, April 2007

accountability

Accountability

Right to an effective remedy

Toebes, April 2007

protection of privacy

Protection of privacy

Data protection

Toebes, April 2007

the human rights impact assessment
The human rights impact assessment
  • Public informed and consulted?
  • Effects on the adequacy of the services?
  • Regulatory mechanisms in place?
  • Means of redress?
  • Medical data protected?

Toebes, April 2007

the international community
The international community
  • WHO;
  • International Health Authority?;
  • General Comment.

Toebes, April 2007